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HomeMy WebLinkAboutSWG2023-00076 - SWG Application / Design - 3/8/2023 JI AS O N COUNTY 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 BELFAIR:360-275-4467,EXT 400 Public Health & Human Services ELMA:360-482-5269,EXT 400 FAX:360-427-7787 On. dte Sewage System Permit: SWG2023-00076 APPLICANT SALTY GULCH LLC Phone: Address: 12216 CORLISS AVE N SEATTLE, WA 98133 OWNER SALTY GULCH LLC Phone: Address: 12216 CORLISS AVE N SEATTLE, WA 98133 SEPTIC DESIGNER TOBY SYRETT-septic designer for B- Phone: 360-426-4221 line Address: 223 SE Cermak Ln SHELTON, WA 98584 SEPTIC INSTALLER DON WOOLLISCROFT B-Line Phone: 360-426-4221 construction Address: 2971 E PHILLIPS LAKE LOOP ROAD SHELTON, WA 98584 Site Address: 291 NE SNOWCAP DR Primary Parcel Number: 222065000072 Permit Description: Repair -3BR Gravity Trench Permit Submitted Date: 03/08/2023 Permit Issued Date: 03/14/2023 Issued By: Jeff Wilmoth Current Permit Fees Paid: $780.00 (additional fees may be required upon installation of system). Permit Expiration Date: 03/14/2026 (based on date of inspection) Permit Conditions: 1 Proposed development subject to zoning requirements and approval by the planning department staff per Mason County Title 17. 2 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 3 Drain field installation not to exceed designed upslope and downslope depth specified on design form. 4 Installer is responsible for obtaining Mason County installation approval prior to backfill of system components. 5 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to backfill of system components. 6 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for final installation approval. THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF OSS. PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE AND EASEMENT LOCATIONS. THIS PERMIT MAY BE REVOKED IF THE SITE CONDITIONS HAVE CHANGED SINCE THE SITE WAS INSPECTED AND DESIGN APPROVED. FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES. For Final Inspection visit: masoncountywa.gov/health/environmental/onsiteloss-inspection-request.php or call: 360-427-9670, extension 400. f OFFICI%AL USE ONLY DATE RECEIVED:3MASON COUNTY • o) COMMUNITY SERVICES AMO1 RECEIVE' : CO • oe" 1►-. ccnn Public Health(Community Health/Environmental Health) C cn 360.427 9670,ext.400 or 360.275.4467,ext.400 � 415 N.6th Street-Shelton,WA 98584 S Y Y///tt��///1��''''V 1 —O 601 4 (n Z c5);. n 13 ON-SITE SEWAGE SYSTEM APPLICATION D m m APPLICANT PHONE m SALTY GULCH LLC C/O B-LINE CONST. INC. 360-426-4221 v z = C MAILING ADDRESS-STREET.CITY.STATE.ZIP CODE C g 2971 E PHILLIPS LAKE RD. SHELTON WA 98584 v m 291SITE RESS-NESTREET.SNOWCAP DR. TAHUYA WA 98588 - < N.)I NAME OF DESIGNER PHONE I N TOBY SYRETT @ B-LINE CONST. INC. 360-426-4221 c NAME OF INSTALLER PHONE I N CD DON WOOLLISCROFT @ B-LINE CONST. INC. 360-426-4221 PERMIT TYPE(select one) DRINKING WATER SOURCE - ID Pr RESIDENTIAL OSS 1 l COMMUNITY OSS G-1 COMMERCIAL OSS 51 PRIVATE INDIVIDUAL WELL ff PRIVATE TWO-PARTY WELL Z I TYPE OF WORK(select One) rz PUBLIC WATER SYSTEM TAHUYA RIVER VALLEY h.NEW CONSTRUCTION/UPGRADES REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) FZI TABLE IX REPAIR 01 SUB 0 SURFACING SEWAGE RI EXISTING FAILURE 0 SHORELINE E DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE CTap OMIQMITTALS I C) 5 WAIVER(S)(IF APPLICABLE) 3 0.46 ACRES 0 o DIRECTIONS TO SITE AND SITE CONDITIONS (ex locked gate) Take North Shore Rd. to NE Belfair Tahuya Rd. Turn Left onto NE Tahuya River Dr. Follow I o to right turn onto NE Snowcap Dr. Go aprox 0.3 mile to gravel driveway on left that leads to I- I o 281 (bare lot) and 291 (with existing mfg home). o I - NISITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. N — OFFICIAL USE ONLY BELOW THIS LINE — ---- UPGRADE/FAILURE SOURCE(for reporting purposes) ❑VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT ['HOME SALE ❑COMPLAINT El OTHER: INSPECTOR SOIL LOGS COMMENTS/CONDITIONS 5r4€. 6>~5/ 7( it c/.✓ IMOW1{1 L61/ 1— 5 ql-'j-(. MAR 0 8 2023 By el" RECORD DRAWING AND INSTALLATION REPORT SOIL CODES: V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL. I P CT SIGNATURE 23 (ii \444c, DATE APPLICATION EXPIRATION DATE AP IC TION APPROV4i -5 — ' 2—(CI ,gi,,,,tED!ISSUED BY DATE /I // I T S AY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015 PAGE /Or OF / SEPTIC SYSTEM DESIGN IMINP • 93 1 22 t 0�2! pf '� • eannerzsunn r ,•\ JOX AC IM!VYAN CK(k • • SITE ADDRESS: 291 NE Snowcap Dr. SITE CITY,STATE ZIP Tahuya, WA PARCEL NUMBER: 22206-50-00072 LEGAL DESCRIPTION: Tahuya River Vally Div #1 Tr 72 OWNER: Salty Gulch LLC DATE: 03 March 2023 B-LINE CONSTRUCTION, INC. - 2971 E PHILLIPS LAKE RD. SHELTON, WA 98584 360.426.4221 office 360.426.0509 fax b-lineconst@msn.com I PAGE Z OF / C4 OWNERSHIP AND USE OF DESIGN DOCUMENTS: a 1. This Design Document has been prepared by B-Line Construction, Inc. via its employees, subsidiaries and sub-contractors. 2. This Design Document has been produced in order to attain an on-site septic system installation by B-Line Construction, Inc. for the property indicated herein. 3. This Design Document represents decades of combined experience of B-Line Construction, Inc. its employees, sub-contractors, etc. in construction processes, technical applications and developments as well as interpersonal understandings and relationships with other professionals, manufacturers, suppliers, regulators, and private parties. 4. This Design Document constitutes physical and intellectual property © B-Line Construction, Inc. and may not be used by any other individual, company, contractor, etc. to construct an on-site septic system for this or any other property. 5. This Design Document shall not be construed as a product that stands alone from the achievement of an on-septic system on the specified property for the client by B-Line Construction, Inc. 6. This Design Document remains the sole property of B-Line Construction, Inc. whether the project for which it was made is executed or not. 7. The submission or distribution of this Design Document to meet official regulatory requirements, or for other purposes in connection with the project, shall not be construed as publication in derogation of B-Line Construction, Inc.'s rights regarding this document as physical and © intellectual property. 8. In the event that B-Line Construction, Inc. is not retained for the installation of the system, this Design Document shall not be used by subsequent parties/contractors. 9. If B-Line Construction, Inc. is not retained for completion of this septic system installation project, subsequent parties/contractors wishing to install an on-site septic system on this property I must produce their own design documents for use in a separate research/development/design/permitting/installation process. 10. If B-Line Construction, Inc. is not retained for completion of this septic system installation project, c lent shall be liable to subsequent parties/contractors for new design documents and additionall permit fees as required in pursuit of re-inspection, re-design and installation. B-Line Construction, Inc. 2971 E Phillips Lake Rd., Shelton, WA 98584 360.426.4221 (office) 360.426.0509 (fax) b-lineconst@msn.corn DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 2 0 6 — 5 0 — 0 0 0 7 2 A design will be reviewed when 3 copies of each of the following are submitted: Completed design form that has been signed and dated. `' Scaled layout sketch, including all applicable items on checklist ." Scaled plot plan, including all applicable items on checklist. Cross-section sketch, including all applicable items on checklist. This form may be scanned and available for public view on the Mason County Web site.Maximum paper si:e: 11"X 17" PARCEL IDENTIFICATION Permit Number: $WG �J)-3_ L )(l74' Designer's Name: TOBY SYRETT @ B-LINE CONST. Applicant's Name: SALTY GULCH C/O B-LINE CONE Designer's Phone Number: 360-426-4221 Mailing Address: 2971 E PHILLIPS LAKE RD. Designer's Address: 2971 E PHILLIPS LAKE RD. SHELTON WA 98584 SHELTON WA 98584 City State Zip City State Zip DESIGN PARAMETERS Treatment Device ❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type: ❑ Aerobic Unit Make/Model ❑ Disinfection Unit Make/Model Other: Drainfield Type 'Gravity 0 Pressure Nf Trench 0 Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 Schedule/Class 3034+ Daily Flow: Operating Capacity 270 AVG gpd Length 68 ft Daily Flow: Design Flow 360 MAX gpd Diameter 4 in Septic Tank Capacity(working) 1200 gal Number 3 Receiving Soil Type(1-6) 3 Separation 6' ft Receiving Soil Appl. Rate 0.8 gpd/ft2 Orifices Required Primary Area I 450 ft2 Total Number of Orifices n/a PERF PIPE Designed Primary Area 612 ft2 Diameter n/a in Designed Reserve Areal 450+ ft2 Spacing n/a in Trench/Bed Width 3 ft Manifold Trench/Bed Length 204 ft Schedule/Class D-BOX Elevation Measurements LltP R 0 V n/a ft Original Drainfield Area Slope 2 - 3 % Diameter n/a in New Slope, If Altered SAME (Ye refeMARnli�fol figur sed? NI Yes 0 No Depth of Excavation Up-slope 13" MAX in ti1AS N COUNTY ENVIRONMENTALE ort Pipe from Original Grade Down-slope 12" in ScheduleJBj 40 Designed Vertical Separation 31" MIN in Length 50' MAX ft Gravelless Chambers Required? 0 Yes 0 No ❑ Optional Diameter 4 in Pump Required? 0 Yes 56No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day n/a Diff. in Elevation Betw4en Pump&Uppermost Orifice n/a ft Dose quantity n/a gal Drainfield Squirt Height/Selected Residual (head) n/a ft ChaFaber Capacity(flood) n/a gal Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff P p ntrols: Please check those required. Capacity @ Total Pressure Head n/a gpm f• " sr. er DElapse Meter 0 Event Counter Calculated Total Pressure Head n/a ft s 'merft1,p p on n/a ,Pump off n/a Comments • • � )O. T. YY1• f."!l ',WTI' s'" ). (,4-:.,,,..:.‘,.. �'t-.ti 4. �--J� lvD E;(Pi:,ES: 06i07/ 2 • r,acoz 7 , of ,___►W DESIGN FORK—PAGE TWO Assessor's Parcel Number:2 2 2 0 6 -- 5 0 -- 0 0 0 7 2 Permit Number: SWG DESIGN CHECKLISTS I Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch El Test hole locations 21 Drainfield orientation and layout Reference depth from original grade: WI Soil logs g Trench/bed dimensions and i Septic tank g Property lines critical distances within layout 171 Drainfield cover ❑ Existing and proposed wells g D-Box/Valve box locations Reference depth from original grade within 100 ft pf property g Septic tank/pump chamber and restrictive strata: QI Measurements to cuts,banks, and locations (71 Laterals,trench/bed,top and surface water and critical areas 121 Observation port location bottom ❑ Location and orientation of 0 Clean-out location 0 Curtain drain collector curtain drain and all absorption 0 Manifold placement 0 Sand augmentation components 0 Orifice placement Other cross-section detail: EZI Location and dimension of g Observation ports/clean-outs primary system and reserve area It Lateral placement with distance to edge of bed Other Information Pi Buildings 0 Audible/visual alarm referenced Yes No 611 Direction of slope indicator EZI Scale of drawing shown on scale g 0 Design staked out g Waterlines bar 0 g Recorded Notices attached g Roads,easements,driveways, System 30+ years old 0 g Waiver(s)attached parking , 0 WI Pump curve attached drain-tiles & gravel filled ❑ Evaluation of failure Fii North arrow and scale drawing with roots. �� shown on scale bar Non-residential justification 0 0 Waste strength 0 ❑ Flow DESI 6' • ' 'OVAL The undersigned designer must be notified b insts ler:a ti ae'of!'stallati.• l Yes_ El p olaiii:. _ate 2 Plf AQ pe Sign; ure offe rgner ':=)' .•(. Date '4R / t , a` Ta.l+i�,-s�azn. :' +f t'UtrNly 4 O c)�_s vFit The undersigned has reviewed this design.,:•,;.- :a,L. 4 '4�_ •: - tits Health and determinedbiti(tN compliance with state and local ite regulations: EX71'Es: ae:/ai/ ew lq(y LT, tii- n ental He Specialist Date �� CAUTION: DESIGN AP ROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. ✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: * 3 _y - - 67 ✓ Drainfield site conditions have not been altered to adversely affect conditions of design approval. Please Note: The system must be installed by a certified installer, unless prior authorization is obtained from Mason County Public Health. An Installation Fee is required. This form may be scanned and available for public view on the Mason County Web site. 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' or 9 2 3 r rO .L'YI.T.Aj.-t4r f i LICENSED OESiCNER FAMES: 0;707/e2 t RESTRICITVE LAYER VALVE BOX ASSEMBLY SECURED SHUT WITH#2 STAINLESS SCREW /f FINISHED GRADE 1 \ FILTER FABRIC 12" 4"SCH 40 PERFORATED LATERAL PIPE O O O O o o op o o o 0 0 0 0 o 0 0 0 0 0 0 2,0 0 0 0 0 0 0 0 0 0 0 0.0 0 0 0 0 0 % y z.Z4s. j,/12,11*/ -;6-2 ,/''1•/,(�7/x, r I / �,(]��yj 1 40,P /V f.lf'C.�`• rys • /: App R 0 V ED TRENCH BOTTOM MAR 1 4 2023 TRENCH CROSS-SECTION, GRAVITY, GRAVEL FOR: GENERAL USE JOB #: MASON COUNTY ENVIRONMENTAL HEALTH PARCEL#: DATE: REVISED SEP 02 JBW BY: TJS DESIGN PAGE 7 OF /0 NORTH ARROW: SCALE: 1" = 1' © TAHJA-SYRETT DESIGNS o' 1' 2 PAGE (0 of ?l GRAVITY DISTRIBUTION SYSTEM System Owner Responsibilities: 1. The prepared site plan is not a survey. It is the owner's responsibility to verify property line locations prior to installation. Any discrepancies must be reported to the contractor immediately. 2. Keep wheeled vehicles off the drainfield area before, during and after installation — tracked vehicles only. 3. All ground and surface water (including roof drains) must be diverted away from the drainfield and tank areas. Ensure that final grade slopes away from these areas and that water does not pool around/behind them. Use swales, berms, along with catch-basins and tight-lines, curtain drains, etc. to divert ground and surface water. 4. Curtain drains can be no closer than 10' uphill or 30' downhill from the drainfield. 5. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the drainfield. 6. Operation & Maintenance is required by the state of Washington and the county for all septic systems. 7. Please contact B-Line Construction for periodic Operation & Maintenance service of your system. 8. System Owner is responsible for having maintenance performed according to the schedule set forth by Mason County. 9. System owner/operator is responsible for responding to malfunctions/backups in a timely manner and alerting maintenance personnel as needed. 10.System owner/operator MUST NOT make changes on settings to the system. Only authorized maintenance personnel may alter/adjust system. 11. System owner/operator agrees to read and abide by information regarding their system in USER MANUAL provided by Mason County. APp B-Line Construction, Inc. R 0 2971 E Phillips Lake Rd., Shelton, WA 98584 M VE 360.426.4221 (office) 360.426.0509 (fax) * NCOUN AR 1 4 2023 b-Iineconst(d msn.com YEN VIRpNME